Objective To compare the activation of microglia in vitro induced by oligomeric and fibrillar Aβ,and research the effects of Piper Kadsura Ohwi extracts on the microglial activation.Methods Microglia were divided randomly into 4 test groups,intervened by fibrillar Aβ25-35,fibrillar Aβ25-35 + Piper Kadsura Ohwi extracts,oligomeric Aβ25-35 and oligomeric Aβ25-35 + Piper Kadsura Ohwi extracts respectively.Also a blank contrast group was set without any intervention.48 hours later,activation of microglia was tested by immunocytochemistry,using the CD68 molecule as a specific marker of microglial activation and the incidences of active microglia in different groups were compared.Results Each of the 4 test groups had a higher positive incidence of CD68 expression than that of the blank contrast (5.1％ ) (P ＜ 0.05 ) ; positive incidence of fibrillar Aβ + Piper Kadsura Ohwi extracts group (52.1％) was lower than that of the fibrillar Aβ group (60.8％) (P＜0.05) ; positive incidence of oligomeric Aβ + Piper Kadsura Ohwi extracts group (67.0％) was not significantly different with that of the oligomeric Aβ group (71.2％),P=0.101.Conclusion Both fibrillar and oligomeric Aβ has the ability to activate the silent microglia.Piper Kadsura Ohwi extracts could inhibit the activation of microglia induced by fibrillar Aβ25-35,but didn't show significant effects on the activation induced by oligomeric Aβ25-35.

BACKGROUND:Intramedul ary nails and locking plates are widely used for two-part proximal humerus fracture. Which is better for two types of implants in patients remains controversial. OBJECTIVE:To determine the clinical outcome of intramedul ary nails versus locking plates for two-part proximal humerus fracture according to Cochrane Meta analysis. METHODS:We searched PubMed, SCI, Embase, the Cochranel Library and CBMdisc, VIP information, Wanfang Database, and CNKI for randomized control ed trials and quasi-randomized control ed trials on intramedul ary nails and locking plates for two-part proximal humerus fracture. RevMan 5.2 software was used to analyze operation time, intraoperative blood loss, fracture healing time, postoperative complications (heterotopic ossification, pain, screw penetration, necrosis of humeral head), and Constant Score. RESULTS AND CONCLUSION:Six articles of clinical control ed trials were included with 259 patients. 131 patients received intramedul ary nails, and 128 patients received locking plates. Meta-analysis displayed that no significant difference in fracture healing time, heterotopic ossification, pain, necrosis of humeral head and Constant Score was detected between intramedul ary nails and locking plates for two-part proximal humerus fracture. Operation time, intraoperative blood loss, and screw penetration were significantly less in the fixation with intramedul ary nails than that in locking plates (P<0.05). These findings suggested that compared with locking plates, intramedul ary nails method for two-part proximal humerus fractures could reduce screw penetration.

Objectives To explore the impact of Aβ oligomer(Aβo) and fibrillar Aβ( Aβf) on the ethology of model rat and to explore whether or not piper kadsura ohwi(PKO) can ameliorate the ethological changes.Methods AD animal model was made by continuous intracerebroventricular infusion of Aβ through mini-osmotic pump.After surgery,rats of Aβo + PKO group and Aβf + PKO group received intraperitoneal injection of 10％PKO everyday,rats from Aβo + DMSO group and Aβf + DMSO group received intraperitoneal injection of 2.5％ DMSO.The treatment lasted 5 weeks.Morris water maze experiment began on the 31st day after surgery.Results ( 1 ) Acquisition trials:the escape latency was longer in Aβo group ( ( 89.40 ± 7.20 ) s ) than that in Aβf group ( (65.00 ± 10.89 ) s ) ; escape latency was shorter in Aβf + PKO group ( ( 34.00 ± 11.26 ) s) than that in Aβf group and Aβf + DMSO group( (60.6 ± 6.95 ) s) ; escape latency was shorter in Aβ3o + PKO group ( ( 65.33 ±8.89) s) than that in Aβo group and Aβo + DMSO group ( ( 85.60 ± 6.02) s).( 2 ) Robe trial:the times ( 3.00 ±0.71 ) and the proportion of time (0.23 ± 0.02 ) and path(0.23 ± 0.04) spent in the target quadrant in Aβo group was less than that in Aβf group(6.00 ± 1.58,0.25 ± 0.01,0.26 ± 0.03 ) ; the three parameters in Aβf + PKOgroup were more than those in Aβ3f group and Aβf+ DMSO group; the three parameters in Aβo + PKO group were more than those in Aβo group and Aβo + DMSO group.Conclusions Aβ oligomer had a more severe impact on the ethology of AD model rats than fibrillar Aβ did; piper kadsura ohwi may ameliorate the ethological changes of AD model rats.

BACKGROUND:Intramedul ary nail and traditional steel plate fixation have been widely used in the treatment of distal tibial (extra-articular) fractures, but these two kinds of methods have shortcomings. Some control studies attempt to answer the advantages and disadvantages of the issue on the treatment of extra-articular distal tibial fractures with intramedul ary nail and steel plate fixation, but the conclusions are different.
OBJECTIVE:To determine the efficiency and safety of intramedul ary nail and plate fixation in the treatment of extra-articular distal tibial fractures by Meta analysis.
METHODS:PubMed, Embase, Cochrane Library, CBMdisc, Weipu information database and Wanfang were searched by computer, and relevant Chinese and English orthopedic journals were hand-searched. Control ed trials related to intramedul ary nail and plate fixation in the treatment of extra-articular distal tibial fracture were included. The quality of trials was critical y assessed. RevMan 5.0 software was used for data analysis.
RESULTS AND CONCLUSION:Four articles were included. Meta analysis showed that compared with the plate fixation, the malunion rate of the intramedul ary nail for extra-articular distal tibial fractures increased. There was no statistical difference in the rate of nonunion rate, delayed fracture healing, and infection rate after operation. These indicate that intramedul ary nail and plate fixation both have good effects on fracture healing.

Background: Insomnia often responds to the orexin receptor antagonist suvorexant. This study aimed to evaluate the efficacy and adverse events of suvorexant for Chinese patients with primary insomnia over 6 months. Methods: A total of 120 patients with primary insomnia were assigned randomly to two groups that received placebo or suvorexant (40 mg) for 6 months. The primary outcomes were the total sleep time (sTST), time to sleep onset (sTSO), and sleep quality (sQUAL). The secondary outcomes were the Insomnia Severity Index (ISI) score and adverse events. Results: A total of 111 patients completed the study and all of them were included in the final analysis. Suvorexant showed greater efficacy than the placebo in enhancing sTST, sTSO, sQUAL and ISI score at months 1 and 6. Serious adverse events were documented in 2 patients (3.3%) in the suvorexant group and 1 patients (1.7%) in the placebo group. The most common adverse event was somnolence, which occurred in 7 patients (11.7%) in the suvorexant group and 2 patients (3.3%) in the placebo group. No death related to suvorexant treatment was recorded. Conclusions: Suvorexant was efficacious and well-tolerated in a group of Chinese patients with primary insomnia over 6 months.
Sleep Initiation and Maintenance Disorders

Objective: To observe the effect oftuina plus music therapy on range of motion of ankle joints and muscle spasm of lower limbs in children with spastic cerebral palsy. Method:All of 286 cases that conformed to the diagnostic criteria of infantile cerebral palsy were treated with 7 types of tuina manipulations respectively to unblock the Governor Vessel, reinforce the kidney and strengthen the spleen, pinch along the spine, stimulate specific foot-reflex area and different spinal segments, accelerate recovery of muscle strength and increase joint range of motion, 25-30 rain each treatment, once or twice a day, 30 d constitute a course of treatment.After this, the efficacy on femoral medial adduction and dorsiflexion angle and composite spasticity score (CSS) was evaluated. Result: The statistical analysis showed significant differences in dorsiflexion and femoral medial adduction angle and CCS scores (P<0.01) after the treatments. Conclusion: Tuina plus music therapy can lubricate the joints, relax contraction of tendons, alleviate muscle spasm and improve scissors and toe-walking gaits, thereby benefiting the gross motor function of infants in sitting, kneeling, standing and walking.

Objective To explore the value of transvaginal three-dimensional power Doppler ultrasound in evaluation of endometrial receptivity in patients with intrauterine adhesions.Methods Totally 43 patients with intrauterine adhesions confirmed by hysteroscopy were enrolled in this study.According to the hysteroscopy,the patients were divided into mild adhesion group (n=17),moderate adhesion group (n=18) and severe adhesion group (n=8).All the patients were examined with transvaginal three-dimensional power Doppler ultrasonography on the day of ovulation.Endometrial thickness (ED),endometrial volume (EV),endometrial vascular index (VI),endometrial flow index (FI) and endometrial vascular flow index (VFI) were compared among three groups.Results There was significant difference in EV among three groups (P＜0.001).ED,VI and VFI were significantly different between the mild and severe adhesion groups,as well as between moderate and severe adhesion groups (all P＜0.05).Conclusion Transvaginal three-dimensional power Doppler ultrasound provides a safe and noninvasive approach to assess endometrial receptivity of patients with intrauterine adhesions.EV has good predictive value on endometrial receptivity.

Objective:To explore the effect of aerobic exercise combined with diet management on volume overload and cardiac function in patients with peritoneal dialysis.Methods:A total of 100 patients who received peritoneal dialysis in the Second Affiliated Hospital of Xi ′an Jiaotong University from August 2017 to March 2019 were recruited in the present study. Patients were randomly divided into intervention group and control group according to the random number table (50 cases in each group). The control group received routine nursing, while the intervention group carried out aerobic exercise combined with diet management on the basis of routine nursing. Before and after 6 months of intervention, the volume status, edema degree and cardiac function were compared between the two groups. Results:After 6 months of intervention, the levels of body weight, 24 h urine volume, 24 h ultrafiltration volume, systolic pressure, extracellular water, and extracellular water/total body water were (58.99 ± 7.30) kg, (366.41 ± 66.92) ml, (565.08 ± 102.24) ml, (142.64 ± 11.70) mmHg (1 mmHg=0.133 kPa), (12.30 ± 2.01) L, 0.39 ± 0.08 in the intervention group, significantly lower than in the control group (63.46 ± 12.90) kg, (431.90 ± 78.92) ml, (625.35 ± 91.31) ml, (150.11 ± 11.44) mmHg, (14.37 ± 4.12) L, 0.43 ± 0.07, the differences were statistically significant ( t values were 2.026-4.208, all P<0.05); the left ventricular ejection fractions, E/A were (61.38 ± 9.42)%, 1.15 ± 0.35 in the intervention group, significantly higher than in the control group (57.04 ± 7.83)% and 1.00 ± 0.29, the differences were statistically significant ( t values were 2.358, 2.113, all P<0.05). After 6 months of intervention, the normal ratio increased and Ⅲ grade ratio decreased in the intervention group, the difference of edema degree between the two groups was statistically significant ( Z value was 3.153, P<0.01). Conclusions:Aerobic exercise combined with diet management can effectively control the volume overload status and improve the cardiac function of patients with peritoneal dialysis.

Objective To explore the influences of family-centered health education on compliance of segregation in children with respiratory infectious disease. Methods The patients of observation group received family-centered health education and included 247 children with respiratory infectious disease who were hospitalized in Hu′nan Children′s Hospital from August to December in 2014 and their parents. The patients of control group received normal health education and included 285 children with respiratory infectious disease who were hospitalized from January to July in 2014 and their parents. The compliance of segregation of the children and their parents were compared between two groups. Results The cognition of the awareness, category and requirement of the segregation, as well as parents′ effective segregate practice of the observation group were significantly higher than that of the control group (χ2 =38. 7,57. 71,30. 36;P<0. 01). Conclusions Family-centered health education can highly improve the compliance of segregation in children with respiratory infectious disease. It can also prevent cross infection and ensure children′s health.

Objective:To evaluate the performance and application of a fast nucleic acid detection system for testing severe acute respiratory syndrome virus 2 (SARS-COV-2).Methods:Clinical samples were collected from February to July 2020 from Beijing Center for Diseases Prevention and Control and the Laboratory Department of China-Japan Friendship Hospital, to evaluate the sensitivity, specificity, anti-interference ability, precision and clinical sample coincidence rate of fast nucleic acid detection system for SARS-CoV-2. The analytical sensitivity was determined by a dilution series of 20 replications for each concentration. Analytical specificity study was performed by testing organisms whose infection produces symptoms similar to those observed at the onset of corona virus disease 2019 (COVID-19), and of the normal or pathogenic microflora that may be present in specimens collected. Potential interference substances were evaluated with different concentration in the interference study. Precision study was conducted by estimating intra-and inter-batch variability. Clinical evaluation was performed by testing 230 oropharyngeal swab specimens and 95 sputum specimens in fast nucleic acid detection system, comparing with conventional real-time fluorescent quantitative PCR (RT-qPCR) and clinical diagnostic results.Results:The analytical sensitivity of SARS-CoV-2 using fast nucleic acid detection system was 400 copies/ml. The result is negative for testing with the organisms that may likely in the circulating area or causing similar symptoms with SARS-CoV-2 and human nucleic acid, indicating that no cross reactivity with organisms. The results of precision test showed that the Coefficient of variation of Ct value of high, medium and low concentration samples was 1.90%-3.92%, and all of them were less than 5% in intra-and inter-batch testing. The results of the samples were still positive after adding the potential interfering substances, indicating that the possible interfering substances in the samples had no effect on the results. 98.46% and 97.85% diagnosis results of fast nucleic acid detection system were consistent with RT-qPCR and clinical diagnostic results, respectively.Conclusion:The fast nucleic acid detection system based on molecular parallel reaction can be used as a selection method for SARS-CoV-2 testing.